Monday, April 20, 2015

A Tale of Two Hips (Written 02/25/15)

A Tale of Two Hips (Written 02/25/15)


I'm starting at the end, but don't worry, I'll go back to the beginning in two shakes of a lambs tail. I haven't written for a while, because I succumb to the post surgery funk. It happened to me after the first surgery and for a moment, a day or two, I thought that I was going to clear that hurtle this time, but I guess it's just a weird part of the healing process. I'm making a point of saying this, because it's extremely confusing, emotionally painful, and it's something that no one that I talked to about surgery brought up that the possibility existed. So I really don't know if this is something that is extremely rare and this is why no one brought it up, or if it's something that passes quickly enough that it's not something that has time to be talked about by patients. I'm sure that the extended years that I spent in chronic pain intensified those feelings. I have no doubt of that, because that was confusing it itself. Which I'll talk more about later.

It happened to me at the point of recovery where I was at home and on my own. I don't think it was avoidable at least for me but I still would have like to have been prepared for it. The second time I tried to get out ahead of it, by making a point of going right to work when I got home, because I knew that was part of it the first time, as I wrote in an earlier post. I needed to get my business plan submitted, if I was going to have any hope of opening my new store this spring. I was supposed to finish it, between the surgeries, but I wasn't able to. It was during those first few days that the bulk of the following was written. And I really thought I had beat it, but it caught me when my hip started to hurt and I got scared that I was sitting up too much and I had to cut the time back. Then the depression hit and the only thing I could do was focus on that business plan. No extra writing, no working on animation, or the Pond Friends script. Business plan. When I finally got the first draft submitted, I slept for two days. Then I started working on the animation logo for the store and now the tide is coming back in and a wave has deposited me back on the beach. (Update: The plan came back and had to be completely reformatted, so this didn't get published when I originally planned, because I had to dive back into the plan.)

I was at least aware of what was happening when the depression came this time, so I knew, like my hip, it would heal. But it is still traumatic none the less. I thought I would make it a point to say this was the most unique thing that I took away from this whole surgery process. The one thing that no one talked to me about prior to my surgery. There is a risk of post surgery depression and it can come on suddenly and passionately. Especially on the second surgery I had regular doses of morphine for the first three days. I don't know anything about morphine, so I don't know if that had anything to do with my crash. I think that most people can work through it on their own. I just stepped up my meditation and brought out my favorite chant, “This too shall pass.”

There's been a paperwork glitch on my physical therapy, I haven't started yet. I started to do things on my own, but without someone monitoring me I was worried I would hurt myself and I was told, on hips, the motto is do no harm. No PT was better than bad PT. My doctor has stepped in to take care of it, so hopefully I'll get started next week. I look forward to simple things, like being able to carry a cup of coffee, without having to find a bag, tie up the lidded cup, and try to carry it without banging it against my cane too much.

So, without further adieu, my story...

Be Careful How You Wish (Or Butter side down week)

After the first hip replacement surgery, when I realized how perfectly my new hip was working, I started wishing that the left hip would go just like the right, only on the opposite side. The opposite side tag line was so I didn't actually wish them into putting a right hip into my left hip. My little wish precaution if you will, embedded in me from all my years of watching Twilight Zone and shows of that nature and the mayhem that would ensue from asking a Leprechaun for a favor.


True to the form of a Twilight Zone episode, For the last 8 days I've felt like I've been living with the mischievous Leprechaun that granted the wish. Before granting me the aforementioned wish he did the usual flourish of explanation that I should consider my wish very carefully, because it would be just as I asked.


I mulled over the many scenarios I'd seen catching the protagonist off guard. I was sure I could be the one to finally beat this shell game with the devil. I came to the conclusion that the downfalls and mishaps endured by the characters, trying to beat the devil, was to make the wish too simple leaving a world mishaps to pile on the unfortunate soul, or and making the wish too complicated trying and cover every angle, but it's always one of the safeguards they've throw in that gets them. So after a lot of thought, I asked my wish in the briefest terms possible without missing any relevant points, to reduced unintended land mines.

I wished that the left hip would go just like the right, only on the opposite side.

Opposite World. Let me start by saying I got the heart of my wish, the part that really mattered, the prize, the thing I really wanted, the exact center of what I was asking for. I wished that my left hip replacement to go just like the right hip only on the opposite side. And that is what I got. The left implant is perfect and I'm thrilled. It's amazing, I'm able to almost completely control the post surgical pain IN MY HIP, with medication, ice packs, and by being careful. I'm already doing short squats, using my walker as a grip to control the movement. It's so wonderful that I feel like I could burst into tears at any moment and probably would if I was alone and didn't have to worry about what someone might think. I wouldn't want someone to misinterpret tears of joy, for pain.


The further away you get from the epicenter of the hip replacement the more wrong things get. That center being the surgery itself and those involved to a level that they would be involved with the surgery in the same way again. All that perfect. Aside from that... Not So Much. Nothing life threatening, or really more than a minor inconvenience, when taken individually. But when you take it all into focus it's like “Really? Really? That's how this is going down?” It started a few nights before the surgery, when I got rear-ended waiting to turn left into the Price Cutter parking lot. We were going shopping for snacks for me to take too the hospital and food for us after the surgery. I sat in the driver's seat trying to convince myself that we hadn't actually had an accident. But there is no denying the sound of crunching metal when two cars kiss. So I pulled into the parking lot and waited for him to do the same. I don't think it could have been a more minor accident. Not so minor that I don't have to get the van fixed, but nothing that really hurt the drivability of the car.

Me getting out of the van.
I felt sorry for the guy, because he had to see me struggle out of the van. By the time I had gotten out he had already asked me if I was alright a few times. I can't imagine what was going to his mind while he watched me go through the twisting, contorting, struggle that is my normal exit from the van.

 As soon as I got down, I said, “I'm all right. Don't worry I was crippled before you hit me.” I didn't know if he'd seen my hop-along plate or not. I got my canes from between the seats and we did to the long walk to the back of the van. It was dark and at first glance I didn't even see anything wrong, but the bumper was bent under right between the support brackets. He had one of those low, wedge shaped, front ends and it had slid in just below the top of the bumper. I had really been hoping it was something that I would be able to live with and it wouldn't require any further thought, but that wasn't the case. It was just bad enough that I was going to need him to get it fixed. I felt bad when I told him, “You won't hear from me for about two weeks, because I'm having hip replacement surgery on Tuesday.” I could tell he was a good guy and that he felt bad about the whole thing.

That was the beginning of a relentless string of Little Annoying Things. I couldn't possibly remember all of them. It was a constant avalanche of things going wrong. Like if I had to use my hands and leaned my canes against something, at least one of them would fall with a loud crack against the floor. Even when, after this had happened several times and I was taking extra care setting them down, I would do something else like knocking the papers off the counter and they would hit the canes and knock them over. Which is a double down, because I don't carry a grabber with me all the time and I have to use my canes like giant chopsticks to pick things up. The only way I have of retrieving something off the floor, without them is to find a sturdy chair, or some other horizontal surface, then do a one handed pushup to get down low enough to grab whatever is out of my reach. When it's a pileup I go for one cane, straighten up, then use that cane to hook the other cane, and go into my chopstick routine to retrieve the rest of the pile.

It was like I had a little prankster following me and darting her little mischievous hands in whenever I let go of something, knocking things on the floor, and spilling my coffee. I also had a continuous stream of unrelated mishaps that included the likes of cats jumping from shelves onto the bed and landing with all four feet pressed into one gravity laden point on my groin. We have 2 cats and 4 - 6 month old kittens. This sort of thing was happening so often that I started keeping a pillow over my groin.

One of the super annoying things that happened revolved around the drug Xaralto. A blood thinner I have to take for 30 days after surgery to help insure I don't get blood clouts. It's a new, super expensive, drug and you have to call before the surgery and get it pre-approved. When I was checking with my pharmacist, I was informed that there was an alternate insurance showing as the primary on my record that didn't pay for the drug and it wouldn't let my insurance through to pay for the drug. After a long round robin of calls I finally reached someone at my insurance company that said she could take care of it, but it would take 24hrs. Which was fine, because my surgery was the next day and I didn't need it until I was discharged from the hospital.

It took me a while to put it together, and understand what was going on, but it was my hospital room that flipped the switch. When I came in for my pre-op blood tests, I requested the same room for my second surgery. For Luck, HA!. It was two weeks before the surgery, and the nurse was confident that I could have the room. I know they tried, because I saw paperwork in the bundle they gave me when I was leaving the hospital, and the right number had been written down. But that room was taken and they had to put me in, wait for it... Yes! The room that was on the exact opposite side of the ward, making the placement of my room backwards.
The mishaps were relentless. At one point, I can't remember what was going on, but it included taking vital signs, questions, moving the surgery hip, and pain. Lots and Lots of pain. Then after everyone had left, and I had time to breath a sigh of relief and relax, I took a tiny sip of water that let a miniscule droplet of water into my esophagus that sent me into a coughing fit that felt like someone had grabbed hold of my surgery leg by the ankle and started jerking it up and down. Or the coffee bath on my last morning in the hospital. I tried to take a sip from a fresh, hot, 16 ounce, cup of steaming coffee, to make room in the cup for milk, so the lid was off... I poured, not spilled, several ounces of scalding coffee onto my chest, with nothing but a hospital gown to protect me. It hurt like a belly flop off the high dive. I made a series of whisper screams, while I blotted at the coffee with my sheet and blanket. Then took the ice pack from my hip and put it on my chest.

Oh and let's not forget the spilled pee across my belly when I was pulling the urinal out from under the covers, because I tilted the urinal and the lid didn't fit tight. The shift in axes caused the liquid race across the length of the urinal. Resulting in a tsunami of pee hitting the lid and opening it. I went through a big pile of wet wipes over that one and no I didn't tell anyone. I had to admit to the coffee, because I had a giant brown Rorschach Test on my chest.

I also had a bed that had a serious butt divot. It was sucking my left hip down at a bad angle and causing me a lot of extra pain and discomfort. I was forever pulling myself out of it, or stuffing blankets under my hip. One of the patient liaisons asked me if I had any suggestions and I told her about the mattress. While I was doing my physical therapy they zinged in a replacement bed which was a big improvement. But in the process, everything got moved out of my reach and I had to immediately call someone in again, so I could get my urinal and pour pee all over myself.

When I woke up from surgery, it was the new high point, in my history of pain. Nothing, not even the first surgery, came close to the pain I was feeling. My mind took a quick inventory: my surgery hip hurt, my tongue hurt, because unlike the first surgery I had bitten it quite hard during surgery, and coming in at number 1, completely unexpected, my left knee was the hot new pain leader on BuzzFeed.

I have been aware of my knee problem, but it was never much of an issue, since I was already using 2 canes, or a walker, to get around, I never put any real weight on my legs. Basically I've been walking like a chimpanzee for the last five years relying on my arms and shoulders to get me around. I have two knee braces. One over the counter brace that is too small, but was the biggest one the store had. It barely fits and I have to constantly put it back on, but it does have some effect for minor pain. Then I have the NASA knee brace that takes NASCAR pit crew to put on and keep adjusted. It works great, but if one adjustment is out of place it causes pain and abrasion sores, where the brace's pressure points.

With my new straight and strong right leg moving easily, my left side got completely blown out with inflammation and after doing physical therapy on the right leg, I ended up having to do three days bed rest to get the pain down to a level that I could get around at all. It never cooled off in my hip, or my knee, before going into the hospital. While you're still under and after the doctor puts your hip in, he moves it all around and while you can't feel it at that moment, you sure as shooting feel it when you wake up.

Come discharge day. We had prescriptions faxed to the pharmacist and there was no trouble with the two cheep drugs. A dollar fifty in copay for two prescriptions. The expensive, anti clotting, drug that could save my life, denied. Back on the phone to travel the country.

I did a round Robin of calls to get it straight, each person telling me to call another person. Then the final number wouldn't ring. I would call it and it would show that it was picked up, but there was no voice there. I called it 3 times. So I went through another three calls to answering machines and then tried it again and somehow this time it rang and a voice greeted me. It turns out that this is not an insurance. It's a VA voucher program for Vets that go outside the VA system for their meds, so the reason the copay is so high is that you're supposed to bring a VA voucher for the meds, but I'm using different insurance for this, but the voucher program is blocking that insurance from working, but as I said, only the super expensive one and the only way of getting past it is to remove my profile. I've never used it, so I imagine that the first need to use it will be an hour after they remove my profile. So she did that. So...

Problem solved! I hang up the phone and immediately knock a fresh soda off the desk. I sat helplessly watching it pour onto the floor, because I didn't have my grabber handy. Fortunately I drink flavored seltzer water so at least it was just water and not corn syrup goo.

Feb 6 2015


So that didn't work. The end result, the reason my prescription wouldn't go through was not because of the voucher program, it was because my insurance, would only authorize the super expensive new drug, once every six months. So my quick thinking pharmacist at Poynor Drug ordered the higher dosage pills and it went through, because that's not the same prescription, and then she cut them all in half for me. Lesson: Always use local pharmacist. If you're getting your meds with insurance, you're not saving money by going to giant corporate pharmacies, but you are giving up personal service and a neighbors job. I'm going to be very sad when Jim decides to retire. I would really hate to see those lights go out. I hope that someone will step up and fill his shoes, and continue Poynor Drug Store's tradition of service to this community.

Now that I'm allowed to take my anti inflammatory pills again, the pain in my knee has finally receded and is not throbbing for the first time in a month. My hips are pain free, I don't even feel them, it's like they're not there and I am... Stunned. I don't really know how to describe the feeling. It's like all those years of pain never existed, like it was just a horrible nightmare. Because after being in pain for so long, no other world seems possible. Now the challenge will be for me to keep it reined in and give my bones times to heal solid, so I'm going to wait until next week to go windsurfing.

Feb 8, 2015

I was able to sleep through the night without taking a round of my post surgery pain pills. I should have taken a set at 1 AM, but I skipped it and made it to 7 in the morning. I'm sore a hell and I had to take them right away, but the pain didn't wake me up in the middle of the night. That is really significant, because up until now I've been drumming my fingers, in serious pain, during the last 30 minutes of waiting for my pills. I couldn't even consider skipping a round. Normally I would have been hyper awake, biting my lip bloody, after going that long. My regular anti inflammatory pills have started to get everything calmed down and for the first time since the surgery, my knee is no longer driving my medication needs.

I can't even come close to walking yet. Though I try to make sure and lift my feet when I'm walking with the canes which is a big improvement over shuffling along at a pace, so slow, that it annoys other cripples. When I'm going up stairs, I can lift my foot, toes pointed straight onto the next stair tread. Before I had to bend my left knee, so I could get my left toes sideways onto the next tread, then I would slide it over a little and using my toes, canes, and the rail, I would lift myself up and drag my right foot up over the stair. So even if I didn't get any better than this my life is so much more comfortable that I'm dizzy half the time thinking about it. I look forward to starting physical therapy. It's been almost 6 years since I could walk, so it's going to take some time, but I believe I will walk again some day. And if you had asked me before the surgery, if I really, really, Really, believed it would be possible that I could walk, I would have said no.

Thank you to all my wonderful friends and family for all the shoulder support through this whole process. It has been quite the journey, though me thinks it just beginning.

Peace,

Alexander

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